running shoes

Running injuries and how to avoid them

ESPH’s foot doctor and marathon runner Scott Corthine gives you his personal take on how to avoid some of the pitfalls that many recreational runners fall into.

Good intentions

running shoes_service headerThere are very few things you can predict in physical medicine. Perhaps some nasty knee injuries during the ski season and the odd over use syndrome in January due to an over-ambitious New Year’s resolution. But as the clocks go forward and the London Marathon approaches  you can seal an envelope containing a list of conditions then open it the Monday after the Marathon and amaze your colleagues as you tick off the last months’ patients one by one.

Most of us went to school.. least you would hope so, and from day one  we were started to move around a little bit quicker in the hall, then the gym and finally on the playing fields, (it was once called PT or PE but I suspect just like metalwork is now called Malleable Materials sport at school goes by a different name now). But anyway, we all did it and most of us tried to avoid it now and then. In my case cross country running in the mud and rain of January was worth a forged note from mum. But because we all did it some of us think we are experts which means when we finally take the plunge and commit to raising £1000s from our mates so we can fulfil that right of passage we download a training program to run 26 miles in less than 4 hours, pull on the shoes festering at the back of the wardrobe and hit the pavements..

Hold it right there

Unfortunately embarking on an ambitious endeavour to run 10k, a half marathon or the full monty is not the same as occasionally jogging round the park. Fortunately science geeks have done the difficult stuff for you and tips on how to improve your performance and avoid injury is all there buried in newspapers and magazines but to save you the trouble of having to plough through them here are a few simple rules to follow:

Feet and shoes

You will need new, quality shoes. Sounds obvious but you would be amazed at how many people overlook this. The science can be baffling but all you need to do is go along to a reputable running shop, get yourself measured and invest in a good pair of supportive, well-cushioned shoes.


Now you may be asked whether you have pronating feet or flat arches and so on. Not sure what that means? well put simply feet fall into one of three types:

  • High arch sometimes called cavus or supinated
  • Low arch /  pes planus, flat or pronated
  • and of course normal/average (if that truly exists!)

The shoe that suits you best depends not only on the type of foot but also your weight, mileage, sex, foot shape, speed and running style. You do not need to over analyses this. Simply find a specialist running shoe shop with well trained staff who can guide you. For almost 20 years I have relied on Run and Become in Victoria ( a family run operation staffed by runners.

You should spend 20-40 minutes finding the right shoe. Some places use video analysis, some the human eye some combine the two. If you’ve been running in the wrong shoe you won’t believe the difference once you put on the right shoe.


Think about what you are trying to achieve. If you want to improve your speed you will need to work on different muscle fibres to those dedicated to endurance.  In an ideal programme you need to concentrate on all the aspects that running involves so a mixed programme of speed work (short bursts working at 75-90% maximum pace) as well as long slow runs to increase the time you can physically sustain is important. Using this approach means you avoid stressing one particular type of fibre allowing you to train more without overusing. Days off to allow muscles to recover and hypertrophy (medical talk for them to grow into what you want – ie. bigger, stronger, faster and less prone to fatigue) are essential.


This is where everybody will argue. Basically it is essential to stretch the muscles you exercise but when? Most of the literature indicates that stetching after activity is the most effective for avoiding future injury and a good regime is – warm up ( gentle movement to promote blood flow to the muscles and preparing them for work) then your training followed by a warm down ( again gentle movement to allow the lactates and waste products to be flushed from the tissues) followed by stretching. Generally you must hold a stretch for 20-30 seconds to make it effective. The key words are gentle and controlled none of the frantic bobbing and lunging you see against the park bench. Isolating the muscle group and holding a correct shape is essential as is concentrating on the groups that are the tightest. If you have tight hamstrings then they will be the most difficult and uncomfortable to stretch and common sense will tell you that sadly they are the stretches you must work on most.


dietUnless you intend to run 100 miles a week forget carbohydrate loading. Sometimes people overeat carbs during training , firstly they put on weight making running more difficult and secondly they can do this at the expense of eating proteins which are essential to build the new muscle you are making. Generally a sensible well balanced diet is sufficient for the semi serious runner. If you’re in doubt and need help then ESPH’s in house dietician can tailor a food programme to compliment your training.


Water is essential and learning to take on fluids whilst running is important and should be incorporated into your training. When it comes to what type of drin is best the research shows that in most cases water is good enough. The electrolyte drinks are mostly effective in getting fluid through the stomach wall quicker than plain water. In British temperatures you are unlikely to need to replace electrolytes over a marathon distance. Energy drinks do not give you energy that is readily available for exercise. This comes from chemicals stored in your body and your ability to increase the storage capacity comes from training pure and simple. Most importantly of all stick to the drink you know. Training for 4 months using water as your drink then taking electrolyte or energy drinks during the event for the first time can be disastrous.

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We welcome today’s news that we can finally reopen our gym facilities from the 25th of July! So there’s just two weeks to wait until we can welcome you all back.

We note our government’s fondness for opening sectors of the economy on Saturdays but we’re not entirely convinced that’s the best day for doing it so will give this some more consideration before we confirm the day we’ll be opening but fear not it will be very close to the 25th and there will be more details on how we’ll be operating to make the space covid-safe in the following week. Be sure to follow our social media channels and check next week’s newsletter for the latest updates.

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